SCORAD Assessment

What is SCORAD? SCORAD, the Scoring of Atopic Dermatitis Index, is an assessment tool used for defining the severity of atopic dermatitis/eczema. It is often used before and after treatment to determine the efficacy of the medication used. Recently it has been adapted as PO-SCORAD “patient-oriented scoring for atopic dermatitis”, a scoring tool to be used for black skin, and has been validated for the same.

What is the SCORAD Assessment based on?

SCORAD is based on both, the physician’s assessment of the extent and severity of the disease, as well as the patient’s subjective assessment of the pruritus and loss of sleep experienced.

How is the SCORAD assessment performed?

A. The extent of the spread of disease is evaluated by the physician using the rule of 9s to establish the body surface area affected. The total area/extent score may range from 0% (none) to 100%.

B. The intensity of the disease is measured using six clinical signs which are each scored from 0- 3, representing intensity as none, mild, moderate, or severe.

The six signs evaluated include:

  • Erythema
  • Swelling
  • Oozing/crusting
  • Excoriation
  • Lichenification/thickening
  • Dryness (only assessed in areas with no inflammation)

The maximum possible intensity score is 18.

C. Subjective symptoms are assessed by the patient on a scale of 0-10 for each symptom- itching and sleepiness.

The two scores are added for a maximum subjective score of 20 (worst imaginable itching and severe sleepiness).

D. The formula for calculating SOCRAD is: A (extent of spread 0-100)/5 +7 B (intensity 0-18) + C (subjective scoring 0-20). 

While the maximum score possible is 103, severity is divided into three groups:

Mild disease ≤ 25

Moderate disease 26-50

Severe disease >50

Source: Maintz, L., Bieber, T., Bissonnette, R., & Jack, C. (2021). Measuring Atopic Dermatitis Disease Severity: The Potential for Electronic Tools to Benefit Clinical Care. The Journal of Allergy and Clinical Immunology: In Practice, 9(4), 1473–1486.e2.